Nasal passageways, for example, are often susceptible to uncontrolled bleeding caused by various forms of trauma, disease or cellular dysfunction. Methods and devices for controlling, limiting or stopping such bleeding would be useful in a variety of situations, ranging from emergency room care to long term care.
Treatment of intestinal diverticular disease would also be facilitated by methods and devices for the prevention and control of bleeding in such diverticula. However, diverticula present a problem in many cases even if they have not advanced to the stage where they bleed. Diverticula are sacral pockets or protrusions in the intestinal tract, derived from the intestinal lumen and of varying sizes, occurring normally through a defect in the muscular coating of the tract.
As shown in FIG. 17, the diverticula of the colon are usually multiple and may be accompanied by inflammation. In the absence of inflammation, the condition is known as diverticulosis, while in the presence of inflammation, the condition is referred to as diverticulitis. Although the distinction between the two conditions is clear when a colon is examined surgically or histologically, the symptoms of colonic dysfunction due to diverticulosis sometimes mimic those of diverticulitis and, therefore, the clinical distinction between the two conditions may often be blurred. Consequently, diverticular disease of the colon typically refers to all stages of the disease from diverticulosis.
Typically globular diverticula communicate with the bowel lumen via a narrow neck through which gas can pass freely. They are prone to filling with fecal material extruded through the lumen that may then become firm. Such a process usually begins in the Sigmoid area of the colon and then typically spreads proximally throughout the intestinal tract over the course of several years. Infection and inflammation occurs in approximately 15-25% of patients with diverticulosis.
Complications associated with diverticular disease include sepsis, fistula, bleeding, obstruction, obstruction, and intractable painful disturbance of the bowel function, with typical septic complications being abscess and perforation accompanied with diffuse bacterial and/or feculent peritonitis. One of the most dangerous complications of diverticular disease is that of bleeding diverticula.
Diverticula usually form at a site where an artery supplying blood to mucosa penetrates the muscular wall of the colon. The penetration of the muscular wall causes a "weak point" and a diverticulum may form, with the result that the artery terminates in the mucosa inside the diverticulum. If the diverticulum becomes infected, or if compacted fecal matter causes an irritation, then the end of the artery may fail causing excessive bleeding. As this bleeding is arterial, it is generally very difficult to control, and major surgery involving the forming of a colostomy and a later (few months) reconnecting the colon or removing a section of the colon is often the only available treatment.
Hemostatic agents, such as carboxymethyl cellulose (CMC) and woven knit or matted fabrics thereof, are known for use in the control of bleeding, such as post-trauma and post-surgical bleeding. CMC is defined as a polycarboxylmethyl ether of cellulose or the sodium salt thereof. It is sometimes referred to cellulose ether, carboxymethylcellulose, or sodium caramellose.